Provider Demographics
NPI:1760651327
Name:ANSON, NANCY W (LPC MAC ACE)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:W
Last Name:ANSON
Suffix:
Gender:F
Credentials:LPC MAC ACE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 N AUDUBON DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3008
Mailing Address - Country:US
Mailing Address - Phone:229-888-9100
Mailing Address - Fax:229-888-9100
Practice Address - Street 1:506 W OGLETHORPE BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-3001
Practice Address - Country:US
Practice Address - Phone:229-888-9100
Practice Address - Fax:229-888-9100
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2087101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor